Riverside Research Institute (RRI) and Focus Surgery, Inc. (FSI) propose an Academic-Industrial Partnership to develop and evaluate advanced ultrasonic means of guiding biopsies and treatment of prostate cancer, particularly treatment using focused ablative ultrasonic therapy. The proposed approach represents a very significant advancement in detection and treatment for this very common cancer of men in the United States and other developed countries worldwide. The proposed RRI-FSI Partnership specifically addresses NIH Program Announcement PAR-07-214, Development and Validation of In-vivo Imaging Systems and Methods for Cancer Investigations. We seek to integrate advanced ultrasonic means of imaging prostate cancer that have been developed by RRI with a proven ultrasonic instrument that has been developed and manufactured by FSI for ablative treatment of prostate cancer. Conventional imaging methods cannot distinguish cancerous from non-cancerous prostate tissue, and consequently, all current biopsy and treatment methods essentially involve the entire gland. By emphasizing combined ultrasonic means of imaging cancer and treating it, we will overcome current imaging limitations, obviating the current need to ablate all tissue in the gland, and enabling treatment to be targeted to image cancerous tissue. This elegant integration of ultrasonic imaging and treatment modalities represents a novel approach to more-effectively treating only cancerous tissue in the prostate while reducing adverse side effects. By providing an effective means of delivering focal treatment, the proposed methods represent a quantum step forward in prostate-cancer management. The significance of these methods extends to biopsy guidance in general and to focal treatments of any type, including surgery, cryoablation, and radiation therapy. The proposed studies consist of three component efforts: 1) expanding our existing prostate-tissue data base and refining our tissue classification methods using transrectal 12-core biopsy histology gold standards; 2) evaluating targeting efficacy using transperineal template-guided saturation-biopsy histology gold standards; and 3) developing methods to identify viable cancer regions in radiation-treated patients who require salvage therapy. The proposed RRI-FSI Partnership will include internationally respected clinical collaborators who are experienced in the use of RRI's tissue-type imaging methods and FSI's ultrasonic ablation instrument. Our clinical collaborators are affiliated with the Virginia Mason Medical Center in Seattle, WA and the University College London Hospitals in London, England.